Carotid Artery Disease

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

How is carotid artery disease diagnosed?

When a person has a TIA or stroke a doctor may take a history to evaluate the source of the bleed. The carotid arteries may be evaluated as a potential cause of the TIA or stroke. This is an important part of the diagnosis and treatment of a transient ischemic attack, since the TIA is a warning sign a stroke may be imminent. Finding a treatable cause and minimizing risk of a future stroke is an important component of patient treatment.

Ultrasound is the most common screening test to determine whether carotid artery stenosis (narrowing) is present. Sound waves are used to understand the anatomy of the artery to see whether narrowing is present. Adding Doppler technology, the amount of blood flow and its velocity can be measured.

Should ultrasound detect carotid artery disease, the next step is to better show the anatomy of the arteries that supply the brain. Angiography is a procedure used to identify any structural abnormalities within the large and small arteries that supply blood to the brain. Historically, angiography was performed with a catheter threaded into the artery and having dye injected to outline the blood vessels. In some patients, the artery anatomy can be seen using CT (computerized tomography) or MR (magnetic resonance) angiograms. In both CT ad MR angiographies, dye is injected into an arm vein, instead of an artery.

What is the treatment for carotid artery disease?

The treatment for carotid artery disease needs to be individualized for each patient and situation. Discuss your options with your doctor. Possible treatments include:

If the carotid artery is less than 50% narrowed, medical treatment is recommended. This includes stepwise antiplatelet therapy. Platelets are blood cells that help clot blood and in patients who have had symptomatic carotid artery disease, meaning that they have experienced a TIA, and decreasing platelet stickiness may be helpful in minimizing future stroke events. The first line medication is to treat the disease is aspirin. If the patient was already taking an aspirin and still experienced a TIA, the next line medication may be dipyridamole/aspirin combination (Aggrenox) or clopidogrel (Plavix).

Medically Reviewed by a Doctor on 11/5/2015

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